When a patient is diagnosed with a sexually transmitted infection, it is important to ensure that any sexual contacts are informed. This helps reduce the spread of infection, reduce risk of health problems for partners and ensure the asymptomatic are aware. The patient should understand the infection, be able to comply with treatment and ensure follow-up arrangements are adhered to. Any patients diagnosed with the following STI’s should have partner notification processes initiated:
- Pelvic Inflammatory disease (PID)
- Hepatitis B
- Non-Specific Urethritis (NSU)
Approaching Partner Notification
It is important to take a sexual history from patients diagnosed with a sexually transmitted infection. This serves to identify anybody at risk, relative risk factors in sexual behavior and acts as a cue for the health professional to remind the patient of who needs to be informed and why.
If the patient is concerned about informing partners, it may help to:
- Point out the risk of re-infection from untreated partners
- Make the patient aware that it is likely partners may not have symptoms, so wouldn’t know unless informed
- Mention that untreated partners may develop long term harm if not informed
- Reassure the patient that there are multiple ways to approach the topic to partners
- Inform the patient that their partners have a right to know of any risks to their health
Discuss with the patient how, where and when their contacts may be informed. Discussing the most appropriate time, place and how to broach the topic can help the patient minimise embarrassment. Usual methods of informing partners would be:
- Face to face
- Social media message
- Text message
- Phone call
Try to encourage patients to talk to contacts privately, rather than in public or on publicly-viewable media networks. It may help to emphasise not to blame anybody, and to tell partners that they have been to the clinic and have been diagnosed with an infection.
If the patient specifies the infection to their partners (for example, saying ‘chlamydia’ rather than ‘an infection’) then the partners can access treatment immediately as a contact, rather than getting a test and awaiting a result prior to treatment. This minimises the risk of further transmission or health complications.
Which contacts need to be informed?
- For men with urethral symptoms, any sexual contacts two weeks prior to the onset of symptoms should be informed
- For asymptomatic men and all women, any sexual contacts within the previous three months should be informed
- If a patient’s last sexual intercourse was more than eight weeks before the onset of symptoms, then the patient’s most recent sexual partner should be informed and treated.
- In symptomatic men, all contacts within four week prior to the onset of symptoms
- For all women and asymptomatic men, all contacts within the last six months (or last sexual partner if no contacts within six months).
- All sexual partners within the last three months for primary syphilis
- All sexual partners within two years for secondary and early latent syphilis.
For Non-Specific Urethritis (NSU) or Pelvic-Inflammatory Disease (PID):
- Four weeks prior to the onset of symptoms in men
- Six months for women and asymptomatic men, or until the last previous sexual partner (if no contacts within six months)
- Contact details should be obtained at the first visit as they may subsequently be found positive for chlamydia or gonorrhoea.
- All current sexual partners should be informed and treated.
- Sexual partners within the time frame of previous testing results or, if no previous results, then depending on risk assessment by the health professional.
For Hepatitis B:
- All sexual contacts or needle-sharing contacts within two weeks prior to the onset of jaundice or until surface antigen negative. Consider vaccinating household contacts or providing immunoglobulin to those at immediate risk. Other contacts dependent on risk assessment by the health professional.